| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,333 |
4,245 |
$287K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,735 |
1,495 |
$143K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,073 |
906 |
$105K |
| 99215 |
Prolong outpt/office vis |
606 |
578 |
$74K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
713 |
711 |
$69K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
564 |
562 |
$54K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
825 |
822 |
$34K |
| 99173 |
|
1,562 |
1,557 |
$31K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,371 |
1,354 |
$30K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
312 |
312 |
$29K |
| 92587 |
|
1,429 |
1,403 |
$28K |
| S9999 |
Sales tax |
2,488 |
1,572 |
$20K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,174 |
1,140 |
$19K |
| 90461 |
|
338 |
337 |
$18K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
616 |
606 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,260 |
1,255 |
$16K |
| 92567 |
|
746 |
606 |
$10K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
87 |
81 |
$6K |
| 99080 |
|
952 |
940 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
61 |
61 |
$2K |
| 90698 |
|
437 |
436 |
$67.32 |
| 90670 |
|
601 |
600 |
$44.88 |
| 90658 |
|
119 |
117 |
$24.27 |
| 90716 |
|
210 |
208 |
$22.45 |
| 90633 |
|
257 |
256 |
$22.45 |
| 90680 |
|
413 |
411 |
$22.44 |
| 90715 |
|
15 |
14 |
$22.44 |
| 90648 |
|
60 |
60 |
$22.44 |
| 90700 |
|
280 |
279 |
$0.01 |
| 90744 |
|
156 |
155 |
$0.00 |
| 90707 |
|
228 |
226 |
$0.00 |
| 90734 |
|
80 |
78 |
$0.00 |
| 90655 |
|
53 |
53 |
$0.00 |
| 90621 |
|
12 |
12 |
$0.00 |
| 90649 |
|
47 |
47 |
$0.00 |
| 90713 |
|
96 |
96 |
$0.00 |